Association of plasma adiponectin and cardiovascular risk profiles in nondiabetic uremic patients on peritoneal dialysis.
BACKGROUND
Adiponectin, a novel adipocytokine with antiinflammatory and antiatherosclerosis properties, has been found to be an inverse predictor of cardiovascular outcomes among uremic patients on hemodialysis. However, its role in uremic patients on continuous ambulatory peritoneal dialysis (CAPD) remains unclear. The aim of the study was to evaluate the association of adiponectin and cardiovascular risk factors in nondiabetic CAPD patients.


METHODS
Sixty nondiabetic uremic patients on CAPD for more than 6 months were enrolled. Plasma adiponectin levels were measured along with cardiovascular risk profiles, including body mass index (BMI), waist to hip ratio (WHR), insulin resistance, lipid profiles, ankle-brachial pressure index (ABPI), brachial-ankle pulse wave velocity (BaPWV), inflammatory markers and peritoneal membrane characteristics. Dialysis adequacy, protein intake, residual renal function and serum biochemistries were also studied.


RESULTS
Plasma adiponectin levels were significantly higher in CAPD patients than healthy subjects (16.0 +/- 11.8 vs. 6.4 +/- 1.8 microg/mL, p<0.001); inversely related to BMI, WHR, triglyceride levels, atherogenic index, insulin levels, homeostasis model assessment of insulin resistance and C-reactive protein (CRP), and directly related to high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). There was also a positive trend between plasma adiponectin levels and the ratios of dialysate to plasma creatinine concentration (D/P Cr). On multivariate regression analysis, BMI and HDL-C were the strongest variables associated with plasma adiponectin levels.


CONCLUSIONS
Hyperadiponectinemia in nondiabetic uremic patients on CAPD is in part associated with cardiovascular risk factors. Whether elevated adiponectin concentrations exert cardioprotective and antiinflammation effects in uremic patients on CAPD warrants further prospective investigation.
Tsao
Yu-Tzu
YT
Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan - ROC.
Hsu
Yu-Juei
YJ
Chu
Nien-Feng
NF
Lai
Ching-Huang
CH
Chiu
Jiann-Shiun
JS
Lin
Shih-Hua
SH
D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010531:Peritoneal Dialysis, Continuous Ambulatory; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014511:Uremia / Q000097:blood* / Q000150:complications / Q000628:therapy; D055815:Young Adult
D052242:Adiponectin; D015850:Interleukin-6; D008055:Lipids; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein